WH Wipro Health Plan ServicesAI Transformation & Modernization
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Wipro Health Plan Services | AI Transformation & Modernization | July 2026

One transformation, two moves: modernize the platform, infuse AI across everything we build.

Wipro Health Plan Services is rebuilding its platform off the mainframe and infusing AI across the business at the same time — new cloud-native products built with agentic development on our AI SDLC, and AI used to modernize the legacy estate. This is the approach, the initiatives in flight, and the proof.

$1.28 → $0.60PMPM target economics
16 initiativestracked in one governed register
6 weeksregulated platform pathway to auditor handoff
2,337published evidence files
Present with arrow keys, space, or the chapter rail.
The starting position

A functional but rigid legacy estate priced every change in months.

The transformation began against a fixed-cost mainframe estate with deep vendor dependency and a shrinking specialist talent pool. The platform worked — but every product change moved at legacy speed, and cost scaled linearly with membership.

$55.0MCurrent annual run rate
$1.28PMPM baseline
9.55MIn-scope LOC inside a 22M LOC environment
6,628MIPS on Ensono-operated mainframe
140h/wkBatch processing, plus 168h OLTP
COBOL · JCL · DB2Core skills concentrated in a diminishing talent pool

Baseline from the January 2026 strategic business case and the April 10, 2026 mainframe migration assessment kickoff.

Our approach

From legacy mainframe to an AI-native, cloud-native platform — one platform at a time.

The strategy is a strangler pattern: build new cloud-native platforms off the mainframe and peel dependency away platform by platform, so the legacy estate shrinks until it can be switched off. We run it two ways at once — building new products with agentic development on our AI SDLC, and using AI to modernize the legacy code itself.

01GroupLink Portal — built
02BrokerLink Portal — built
03ServiceLink Portal — next
04Remove backend dependency
05Retire the mainframe
Build new: agentic products on the AI SDLC Modernize legacy: AI-assisted COBOL migration

Where we are now: the new platforms run cloud-native on their own PostgreSQL, but still depend on the mainframe database via CDC sync and backend batch processing for payments and communications. The next move is event-driven, real-time capability that retires the batch dependency and lets the legacy estate die on the vine.

Proof of capability — the 2025 pilots

Three 2025 pilots proved the model — all completed, and each now carries into the platform program.

Before scaling, the team ran three pilots in 2025, each proving a different part of the approach: build greenfield, modernize legacy code with AI, and ship new regulated capability. All three completed successfully and graduated into the production platform program.

New group platform buildGreenfield, fully cloud-native — eliminated mainframe dependency for the build. Carried into GroupLink Portal.
COBOL module transformationLegacy COBOL rebuilt off the mainframe with AI-assisted transformation — 180% faster development, 65% fewer defects, zero production downtime.
ICHRA for ServiceLink PortalNew ICHRA capability delivered full-stack for SLP — 100% complete, proving new regulated product delivery.

Three pilots completed in 2025 (per the AI Factory strategy deck); pilot metrics as reported at completion. They establish the capability the 2026 platform program builds on.

The strategy and destination

$0.60 per member per month — a 52% run-rate reduction on an evidence-gated path.

Savings are counted when workloads are verifiably retired — not when code is migrated. That discipline keeps the case credible.

Source basis: WHPS AI Transformation strategic business case, January 2026.

The transformation roadmap

A phased path from foundation to mainframe exit — with wins at every stage.

The program runs two tracks at once: platform modernization and AI transformation. Each phase is expected to land usable, evidence-backed capability — so value compounds along the way rather than arriving only at the end.

2025 · Foundation Engine and first wins

AI SDLC stood up as the delivery method; Recon Buddy phase 1 live in production since December 2025.

2026 H1 · Proof Platforms on the board

Regulated broker pathway to auditor handoff in six weeks; GroupLink modernization; Contact Center AI in production.

2026 H2 · Scale Portfolio and decision

Sixteen governed initiatives; Contact Center AI family expanding; modernization approach decision on the table.

2027+ · Exit Mainframe retirement

Coexistence cutover, batch and payment carve-out, and verified decommission toward the $0.60 PMPM target.

Wins along the way — not a single payoff at the end of a multi-year arc.

The delivery engine

The WHPS AI SDLC Factory: Agile discipline adapted for agentic delivery.

Delivery speed comes from a documented, model-agnostic operating method — not from any single tool. Agents execute bounded work inside scoped workspaces; humans own the gates; every release ships with a typed evidence packet. The method itself advances with each initiative it delivers.

01Define and strategize
02Decompose and plan
03Architect and design
04Build and integrate
05Validate and secure
06Deploy and release
07Monitor and evolve
13 security and compliance gates sit on top of AI-assisted delivery
01–04 Intake and design assurance 05–08 Build and runtime security 09–12 Access, data, and operations 13 Final risk acceptance
Model agnostic Evidence first Human governed Agent ready

Pilot results across the 2025 builds: 180% faster development and 65% fewer defects versus traditional delivery, as reported at pilot completion.

Security is a release condition, not a late-stage advisory step. See the full AI SDLC control plane and diagrams →

Building toward AI-native

Every initiative leaves a reusable AI-native capability behind.

The initiatives are not just products. Each one proves and hardens a durable capability that the next build reuses — so the program moves toward an AI-native operating model with every delivery, not only at the finish line.

Agentic deliveryThe AI SDLC Factory — proven across every platform build.
Voice and language AIContact Center AI — live IVR, multilingual flows, agent assist.
Conversational data accessSQL Talk — natural-language querying of membership data.
Autonomous reconciliationRecon Buddy and ReconLink — discrepancy detection and recommendations.
Document intelligenceAI Seed Image-to-Text — structured data from source images.
Regulated greenfield buildMarketLink — a CMS EDE platform delivered at AI SDLC speed.
Legacy coexistenceGroupLink — cloud-native build with a live data-modernization bridge.
Evidence by designTraceability and audit packaging built into delivery, not bolted on.
Reusable platform capitalPatterns that lower the cost and risk of every platform that follows.

Capabilities describe the target AI-native operating model the program is building toward as initiatives complete.

Every initiative in flight

One governed register: sixteen AI initiatives, grouped by capability family.

This is the whole portfolio at a glance — from the platform builds to the Contact Center AI family, reconciliation, and the operational AI tools. The following chapters walk each family in turn.

Platform builds2
  • BrokerLink Portal / MarketLinkDemo / evidence ready
  • GroupLink PortalModernization proof · active
Contact Center AI9
  • Voice Assist — Benefits & EnrollmentRelease in progress
  • CCAI ClaimsAt risk: complexity · Aug 2026
  • Agent Assist ET Log CreationAt risk: Verint · Oct 2026
  • Contact Center VOC QADiscovery · Sep 2026
  • Transcription Audit AutomationOn hold · leadership decision
  • Group / Benefits & EnrollmentBlocked: integration
  • MHC IVR Billing & EnrollmentQueued
  • Contact Center AI Phase 3Queued
  • Self-Service / BPaaS Call CenterYet to start
Reconciliation2
  • Recon BuddyLive phase 1 since Dec 2025
  • ReconLink PlatformUAT remediation
Data & document AI2
  • SQL Talk for KPBusiness UAT · July 1 target
  • AI Seed Image-to-TextOperational
Strategic1
  • AI Transformation & Platform ModernizationAWS proposal pending

Statuses per the July 1, 2026 portfolio register. Dot colour: green live · blue active · red at risk · amber decision · grey queued. Open the full register page →

Initiative detail: Contact Center AI

Contact Center AI: a family of capabilities, from live IVR to claims and quality.

Contact Center AI was the first production validation of the AI Factory model — proving the on-premise approach with real member interactions before the platform builds began. The AI contact center path handles five call types today, with Spanish-language flows deployment-ready and a roadmap of capabilities expanding behind it across claims, quality, and after-call work.

  • Voice Assist — Benefits & EnrollmentRelease in progress · Spanish IVR; recording vendor replacement after Verint rollback
  • CCAI ClaimsBRD in progress; Ops Portal API review next · target Aug 2026
  • Agent Assist ET Log CreationAfter-call work automation; Verint dependency and 48-hour KPI · target Oct 2026
  • Contact Center VOC QADiscovery with business SME; phased quality scoring · target Sep 2026
  • Transcription Audit AutomationCost-benefit complete; awaiting leadership proceed / defer
  • Group / Benefits, MHC IVR, Phase 3Blocked on integration or queued for prioritization
Initiative detail: GroupLink Portal

GroupLink Portal: the modernization the legacy pattern never produced.

Group and CSR operations sat on an antiquated legacy experience — dense screens, manual navigation, green-screen-era operating patterns — that stayed in place for years under conventional delivery constraints. The AI-native lane built the modern platform: role-aware workflows, guided onboarding, and the data and service modernization underneath it.

  • Dual-track build: modern experience on top, database and service modernization underneath — not a UI refresh.
  • Database migrated to PostgreSQL with an IBM CDC bridge keeping DB2 in sync during coexistence.
  • Reusable modernization bridge: the same pattern is designed to carry ServiceLink Portal and other DB2-dependent applications.
Status: modernization proof — active lane
Initiative detail: BrokerLink Portal

BrokerLink Portal (MarketLink): a regulated CMS EDE platform pathway in six weeks.

The team took a greenfield broker and agent enrollment platform from concept to auditor handoff in six weeks — a pathway conventionally sized at 8–12 months. It was built inside the AI SDLC, with security review, compliance input, and evidence collection running as part of delivery, not after it.

Conventional planning baseline 8–12 months

8,500–10,500 estimated hours

AI-enabled delivery path ~650–900 hours

Six weeks to auditor handoff

Planning comparison against the conventional sizing baseline.

Status: demo / evidence ready — prepared for third-party assessment and the CMS certification path
Initiative detail: ReconLink

ReconLink: reconciliation modernized, from assistant to platform.

The enrollment and premium reconciliation lane shows the delivery model working inside messy operational reality. Recon Buddy, the reconciliation assistant, has been live in production since December 2025; the full ReconLink platform rebuild is now in final UAT remediation.

  • Recon Buddy phase 1 live since December 2025 — the program's first production win.
  • NERD Next integration accuracy improved from 35% to 42% across three test rounds.
  • Two open UAT items — an EDI policy ID mismatch and verbose recommendation output — with a round-2 business signoff session in motion.
Status: Recon Buddy live — ReconLink in UAT remediation
Initiative detail: operational AI

Operational AI tools: data access and document intelligence, already in hand.

Beyond the platforms, smaller AI tools remove day-to-day friction and prove new capabilities in production — each one a building block toward the AI-native operating model.

  • SQL Talk for KPConversational access to membership data · in business user testing, production deployment targeted July 1, 2026, outcome pending register update
  • AI Seed Image-to-Text ConverterStructured text from source images · operational, business-reported issues resolved
Status: one in business UAT, one operational
Proof discipline

Speed that leaves an audit trail.

Every requirement row traces from CMS source through backlog, delivery gate, test kit, and evidence reference. The evidence system was developed with the platform, so audit readiness is part of delivery — and no external claim outruns the evidence.

100%Traceability coverage — 21 rows, 8 requirement areas, 13 FIT cases
2,337Published evidence files in the review-ready vault
6,969Rows in the full traceability index
42Current UAT artifacts (May 16, 2026 snapshot)
40 / 45Security findings documented as fixed in remediation status
May 11Third-party assessment planned from the week of May 11, 2026; outcomes pending

Traceability coverage and auditor evidence completion are tracked as separate statuses — current FIT evidence capture is in progress, and external claims are timed to completed audit and certification evidence.

What this unlocks

The proven delivery engine now points at the mainframe exit.

GroupLink's coexistence bridge de-risks the DB2 migration waves. The MarketLink pathway proves regulated delivery at AI SDLC speed. The AWS modernization proposal — preview received June 24, 2026, with the formal proposal as the next decision input — frames the sequencing decision now on the table. The same platform is designed to be future-ready for new markets: ICHRA, Medicare, and Medicaid.

FY26Peak build

Build and assessment investment peaks while the legacy run rate holds.

FY27Coexistence and cutover

Parallel-run inflection: workloads move with rollback protection.

FY28Savings capture

Decommission savings land as retirement is verified.

FY29Optimized run rate

Steady-state economics approach the $0.60 PMPM target.

Decision velocity now determines scale. See the vendor decision room →

Close

The pattern is proven. The decision is where to scale it first.

WHPS has demonstrated a secure, compliant, AI-native delivery capability — with production value, platform proof points, and an audit-ready evidence system landing along the way, not just at the end of the arc.

6 weeksregulated platform pathway
$0.60PMPM target economics
16initiatives under one governed register
100%requirement traceability coverage